Provider Demographics
NPI:1851052377
Name:GLEASON, BRIA (TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:BRIA
Middle Name:
Last Name:GLEASON
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-2810
Mailing Address - Country:US
Mailing Address - Phone:267-266-8077
Mailing Address - Fax:
Practice Address - Street 1:111 S 4TH ST
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-2810
Practice Address - Country:US
Practice Address - Phone:267-266-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist